Non-Hodgkin's lymphoma
ICD10 Diagnosis | |
Dx: | Non-Hodgkin's lymphoma |
ICD10 code: | C85.7 |
Pre-ICD10 counterpart: | Lymphoma |
Charlson/ALERT Scale: | Any malignancy, including lymphoma and leukemia, except of skin |
APACHE Como Component: | Immunocompromised |
APACHE Acute Component: | none |
Start Date: | |
Stop Date: | |
External ICD10 Documentation |
This diagnosis is a part of ICD10 collection.
Additional Info
See Non-Hodgkin lymphoma on wikipedia for more info, but understand that we group lymphomas slightly differently than they describe.
Includes
- Diffuse large B-cell lymphoma.
- follicular lymphoma
- Anaplastic large-cell lymphoma.
- Burkitt lymphoma.
- Marginal zone lymphoma which includes MALT lymphoma
- High grade B cell lymphoma (HGBL) previously known as double-hit lymphoma
- Mantle cell Lymphoma (MCL) (sometimes falsely called "Mantle cell leukemia")
- Small lymphocytic lymphoma (SLL) is an indolent (slow growing) non-Hodgkin lymphoma that affects B cells
Leukemia vs Lymphoma
Any lymphoma may have a leukemic phase where the abnormal clonal cells appear in the circulation. Though this is sometimes referred to as a "leukemia", even by some oncologists, that is technically incorrect and ICD10 considers them to be lymphomas. This applies to essentially ALL so-called B-cell leukemias, which are actually lymphomas. It also applies to "NK-cell leukemia" which is also a lymphoma
As such, the following so-called "leukemias" should be coded as follows:
- So-called B-cell leukemias describes several different types of lymphoid lymphomas which affect B cells -- and all these should be coded as Lymphoma, NOS
- "B cell chronic lymphocytic leukemia"
- "Precursor B cell lymphoblastic leukemia"
- "Acute Lymphoblastic leukemia, mature B cell type"
- "B cell prolymphocytic leukemia"
- So-called "NK-cell leukemia" -- code as T-cell lymphoma
- Aggressive NK-cell leukemia (also called aggressive NK-cell lymphoma, or ANKL), is a very rare type of NHL. The body makes large numbers of NK cells that are larger than normal. It is grouped with T-cell lymphomas.
- There is a very rare slow-growing (indolent) type of NK-cell leukemia that has a more favorable prognosis. It is called chronic NK-cell leukemia and is treated like T-cell large granular lymphocytic leukemia.
- The most common type of lymphoid leukemia is B-cell chronic lymphocytic leukemia.
Using ICD10 Malignancy Codes as a Comorbid Diagnosis
- Any cancer/malignancy (either a "solid tumor" or a leukemia/lymphoma/bone marrow malignancy/"liquid tumor", i.e. any ICD10 code from C00-C99) can be a comorbid diagnosis --- BUT it's vital to distinguish malignancies in this category based on whether they are believed to be cured or not.
- If it's still present (or believed to be present), then just include the code for the specific cancer as a comorbid diagnosis.
- If INSTEAD, it's presumed cured, then in the "bin" of comorbid diagnoses combine the code for the specific cancer with this code: Past history, cancer (any type), believed cured
C00-C99 codes codes: |
Metastases
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Regarding Presumptive Diagnosis of Malignancy
- Rarely a presumptive diagnosis is made without any tissue confirmation. This generally occurs with:
- risk of obtaining tissue is very high
- plan would be palliative regardless
- patient would refuse care regardless.
- Our issue for how to code a presumed malignancy without definitive histopathologic proof is this:
- If the physicians are going to proceed with a treatment plan without that definitive histopathologic proof --- then code whatever is their best guess about what is present. Example: believed to be lung cancer with a big brain met, and they've decided NOT to do any biopsy but to give palliative radiation therapy, then you'd code lung cancer, and met to brain.
- If the plan is to obtain a definitive histopathologic diagnosis soon or in the future, then instead code: Neoplasm of uncertain behavior (i.e. not clear if benign or malignant), NOS
"work-up for cancer"
If the cancer has not been confirmed then it should not be coded as cancer. Code relevant test abnormal test results or symptoms.
Testing codes: |
Symptom/Sign codes: |
Example: |
Alternate ICD10s to consider coding instead or in addition
Lymphoma codes: |
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
Related Articles
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